Is this on your radar ? When first evaluating a patient and creating a differential diagnosis, if t’s not on your radar it may likely get missed. Case #1 A 47 yr old female presents to the emergency department via private vehicle from home for evaluation of …

Ultrasound measurement of the optic nerve sheath diameter is a simple non-invasive procedure, which is a useful tool in the assessment of elevated intracranial pressure. Early identification of elevated ICP (intracranial pressure) is critical to ensuring timely and appropriate management. However, there are few …

A 45 yr old male presents with left foot pain. The patient claims he had a mechanical slip and fall down the stairs last night and his body weight fell on his left foot, which was folded beneath him. His left foot is edematous with some mild ecchymosis noted laterally. Patient …

A 23-year old male presents to the emergency department with symptoms of dizziness and palpitations. He was playing basketball one hour ago, when after a brief sprint down the court he felt quite dizzy and short of breath. He sat down to rest, but the symptoms persisted. He has …

The HINTS exam is a three-part, rapid beside oculomotor test used to help differentiate central from peripheral vertigo. HINTS stands for Head Impulse, Nystagmus and Test of Skew. The test consists of three parts: 1 – Patients with peripheral vertigo will have abnormal (positive) head impulse testing, while patients …

A 44 year-old male is brought in by EMS after an accidental heroin overdose. The patient was found sitting in his car unconcious and apneic with pin-point pupils and drug paraphernalia in the vehicle. The patient was resuscitated with 2 mg of intranasal Narcan (Naloxone) followed by another 2 …

A 45 yr-old male arrives via ambulance in the emergency department found lying on the sidewalk unresponsive but with stable vital signs and no acute signs of trauma. The patient is very well known to EMS and emergency department staff and has a history of chronic alcohol abuse. Upon …

A 39 year-old female presents to the emergency department by ambulance from home with worsening dyspnea and fatigue over the past 3 days. She is 6 days post-partum after an uncomplicated full-term vaginal delivery. This is her first pregnancy, during which she had developed gestational hypertension in the last …

Working in the emergency department it can be difficult to keep up with all the new street drugs. Here is yet another one….coming soon to an ER near you. Dab, Dabs, Dabbing, wax, earwax, honey, honey oil, shatter and BHO are all street names for a new form …

A new designer drug has emerged on the teen scene. 2C-I-NBOMe, also known as “N-bomb”. This new drug is an extremely potent hallucinogenic stimulant and has been associated with multiple deaths. NBOMe is often sold under the pretense that it is LSD, however, unlike LSD, NBOMe also has …

Many people find medical mnemonics very helpful for remembering certain differentials, presentations or toxidromes. Hopefully you too will find this new segment useful. This 4-yr male male is brought in for evaluation for rash and fever for 5 days. …

A 26 year-old male with acute alcohol intoxication presents to the emergency department with complaints of substernal chest discomfort which is made worse with deep inspiration. The symptoms began 1 hour ago after three episodes of vomiting. His vital signs and ECG are unremarkable. He has no cardiac risk …

This post is a follow-up to the post and video “Difficult Airway Management : The Elaine Bromiley Case” – please watch the initial video prior viewing this post. “Using the circumstances of a real case as a starting point, this video demonstrates …

The Elaine Bromiley Case “This video, produced by Simpact with the permission of Martin Bromiley, is primarily intended for the education of healthcare clinicians, particularly those involved in advanced airway management. By providing a more immersive, real-time version of events which includes some technical detail, the hope is that …

“Flakka”(alpha-pyrrolidinopentiophenone) is a dangerous synthetic cathinone, similar to “bath salts” that is spreading across the country. This drug is a white or pink, foul-smelling, crystal that can be injected, snorted, eaten or vaporized. Flakka and can cause an “excited delirium” that involves hyperstimulation, paranoia, and hallucinations that can lead to …